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Hospital oversight in Medicare: accreditation and deeming authority. 医疗保险中的医院监督:认证和认定权威。
NHPF issue brief Pub Date : 2005-05-06
Lisa Sprague
{"title":"Hospital oversight in Medicare: accreditation and deeming authority.","authors":"Lisa Sprague","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To be eligible to receive payment from Medicare, hospitals must be certified to meet certain conditions. Hospitals may gain such credentials by choosing to be reviewed by a state certification agency under contract to the Centers for Medicare & Medicaid Services or to be accredited by either the Joint Commission on Accreditation of Healthcare Organizations or the American Osteopathic Association. This issue brief looks at how accreditation of hospitals developed and how it continues to change. It considers the legal and practical reasons that a majority of hospitals choose accreditation and why some hospitals do not, along with broader consideration of the extent to which accreditation may be judged of value to Medicare beneficiaries. The intersection of state and federal oversight responsibilities and the role of accrediting organizations in hospital quality improvement also are examined.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 802","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2005-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25116108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The provider system for children's mental health: workforce capacity and effective treatment. 儿童心理健康提供者系统:劳动力能力和有效治疗。
NHPF issue brief Pub Date : 2004-10-26
Jane Koppelman
{"title":"The provider system for children's mental health: workforce capacity and effective treatment.","authors":"Jane Koppelman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This issue brief examines two issues that are key to meeting children's unmet needs for mental health care: ensuring that the provider supply is adequate and that the care delivered is effective. It describes the shortage of qualified providers to address children's mental disorders, as well its possible causes; it describes how managed care, to a certain extent, drives practice patterns; and it discusses the gray areas in deciding which providers are most qualified to deliver what care. In addition, this paper introduces what is known about evidence-based care in children's mental health, the extent to which it is being taught and practiced, the extent to which health plans are adopting such practices, and the effect such strategies may have on the makeup of the children's mental health provider field.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 801","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2004-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24801099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electronic health records: How close? How far to go? 电子健康记录:有多接近?要走多远?
NHPF issue brief Pub Date : 2004-09-29
Lisa Sprague
{"title":"Electronic health records: How close? How far to go?","authors":"Lisa Sprague","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper looks at the central role of the electronic health record (EHR) in health information technology. It considers the extent to which EHRs are in use and initiatives designed to increase their prevalence, as well as barriers to the widespread adoption of EHRs and efforts to surmount them. Particular attention is given to such obstacles as cost, the professional culture of physicians, standardization, and legal questions.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 800","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2004-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40908597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Children with mental disorders: making sense of their needs and the systems that help them. 精神障碍儿童:理解他们的需求和帮助他们的系统。
NHPF issue brief Pub Date : 2004-06-04
Jane Koppelman
{"title":"Children with mental disorders: making sense of their needs and the systems that help them.","authors":"Jane Koppelman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper examines the nature, severity, and prevalence of mental, behavioral, and emotional disorders among children, as well as the types of services that could help them. It looks at how they are served by the education, health care, and child welfare systems, and it identifies the gaps in these systems of care. It also examines the extent to which Medicaid, SCHIP, and private health insurance finance mental health care services for children.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 799","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2004-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24567296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Consumer cost sharing in private health insurance: on the threshold of change. 私人医疗保险的消费者成本分担:在变化的门槛上。
NHPF issue brief Pub Date : 2004-05-14
Veronica Goff
{"title":"Consumer cost sharing in private health insurance: on the threshold of change.","authors":"Veronica Goff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, co-pays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 798","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2004-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24525600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare's chronic care improvement pilot program: what is its potential? 医疗保险的慢性护理改善试点项目:它的潜力是什么?
NHPF issue brief Pub Date : 2004-05-10
Nora Super
{"title":"Medicare's chronic care improvement pilot program: what is its potential?","authors":"Nora Super","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician's role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 797","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2004-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24525598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Veterans' health care: balancing resources and responsibilities. 退伍军人的医疗保健:平衡资源和责任。
NHPF issue brief Pub Date : 2004-04-01
Lisa Sprague
{"title":"Veterans' health care: balancing resources and responsibilities.","authors":"Lisa Sprague","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper looks at the health care benefits and services administered by the U.S. Department of Veterans Affairs. It examines management strategies adopted within the department to allocate resources, structure benefits, and improve quality. Some recommendations made by the General Accounting Office and the President's Task Force to Improve Health Care Delivery for Our Nation's Veterans are reviewed, in particular the emphasis of the latter on increased collaboration with the Department of Defense. Long-term proposals to balance service commitments and financing also are considered.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 796","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2004-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24482503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sailing SCHIP through troubled waters. 医疗保险计划（SCHIP）渡过难关。
NHPF issue brief Pub Date : 2003-11-13
Jennifer Ryan
{"title":"Sailing SCHIP through troubled waters.","authors":"Jennifer Ryan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As the State Children's Health Insurance Program (SCHIP) enters its sixth year of operation, states have continued their commitment to children's coverage and to reaching out to the uninsured. This issue brief explores the current status of SCHIP in light of fiscal pressures that have been created by the state budget crisis. It highlights some of the key successes in the program thus far and notes several examples of state initiatives to serve particularly vulnerable populations and collect outcomes data and information about access to care.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 795","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2003-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24130915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dually eligible for Medicare and Medicaid: two for one or double jeopardy? 双重资格的医疗保险和医疗补助:两赔一还是双重危险?
NHPF issue brief Pub Date : 2003-09-30
Jennifer Ryan, Nora Super
{"title":"Dually eligible for Medicare and Medicaid: two for one or double jeopardy?","authors":"Jennifer Ryan,&nbsp;Nora Super","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This issue brief describes the characteristics of the population of individuals known as \"dual eligibles,\" who are eligible for health insurance coverage through both Medicare and Medicaid. It also looks at the differences between \"full Medicaid\" and \"supplemental Medicaid\" dual eligibles and the ongoing challenges associated with enrollment and eligibility, integration and coordination, and managed care. The paper presents several examples of integrated care programs designed to better serve the dual-eligible population, including the Program of All-Inclusive Care for the Elderly, Evercare, social health maintenance organizations, and state/federal initiatives such as the Wisconsin Partnership Program, Texas STAR+PLUS, and others. Finally, it considers the implications for dual eligibles of the House and Senate Medicare prescription drug proposals.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 794","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2003-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24010089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Medicare prescription drug proposals and health insurance risk. 医疗保险处方药提案和健康保险风险。
NHPF issue brief Pub Date : 2003-09-04
Dawn M Gencarelli
{"title":"The Medicare prescription drug proposals and health insurance risk.","authors":"Dawn M Gencarelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In order to facilitate a better understanding of the complex issues raised by the current Senate and House proposals to establish a prescription drug benefit for Medicare beneficiaries, this paper briefly addresses some fundamentals of the health insurance market, defines key risk-sharing mechanisms, including risk corridors and reinsurance, and identifies the relevant risk provisions in the bills. Other issues related to cost management strategies and program design, which may have an impact on cost and adverse selection, are briefly discussed.</p>","PeriodicalId":83826,"journal":{"name":"NHPF issue brief","volume":" 793","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2003-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22568444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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